Information Collection

National Firefighter Registry

IC 240040 under ICR 201806-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment C Focus Group ModGuide _ 1.30.20.docx	Other-WORd
Attachment D Potential Survey Tool Questions.docx	Other-WORD
Attachment E FG Demographics questions.docx	Other-WORD
FormforFG LMM 9.27.19.docx	Other-WORD
HMTSExpediteForm v3 LMM.pdf HMTS Expedite Form	IC Document
Attachment A Background _ 1.30.20.docx Att A_Background	IC Document
Attachment B Informed Consent.docx Att B_Informed Consent	IC Document
List of Attachments.docx List of Attachments	IC Document

IC Title:

National Firefighter Registry

Agency IC Tracking Number:

0920-0572-20KG

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-WORd	Attachment C Focus Group ModGuide _ 1.30.20.docx	No	Fillable Fileable
Other-WORD	Attachment D Potential Survey Tool Questions.docx	No	Fillable Fileable
Other-WORD	Attachment E FG Demographics questions.docx	No	Fillable Fileable
Other-WORD	FormforFG LMM 9.27.19.docx	No	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,060

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,060	2,060
Annual IC Time Burden (Hours)	520	520
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HMTS Expedite Form	HMTSExpediteForm v3 LMM.pdf	02/21/2020
Att A_Background	Attachment A Background _ 1.30.20.docx	02/21/2020
Att B_Informed Consent	Attachment B Informed Consent.docx	02/21/2020
List of Attachments	List of Attachments.docx	02/21/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.